Department of Medicine and Health Sciences 'Vincenzo Tiberio', University of Molise, Via Giovanni Paolo II, 86100, Campobasso, Italy.
Orthopaedics and Traumatology, Department of Biotechnology and Life Sciences (DBSV), University of Insubria, Varese, Italy.
Int Orthop. 2019 Jan;43(1):209-215. doi: 10.1007/s00264-018-4164-8. Epub 2018 Oct 2.
Management of acute open tibial fractures with critical bone defect remains a challenge in trauma surgery. Few and heterogeneous cases have been reported about the treatment with the induced membrane technique.
We prospectively evaluated three patients treated with the induced membrane technique for acute Gustilo IIIB tibial fractures with critical bone defect. Success treatment was defined by bone union with patient pain free. Clinical and radiological evaluations were performed regularly until healing, then annually and with a minimum follow-up of five years.
In all patients but one, a success was recorded, respectively, at four and six months. These two patients were pain free until the final follow-up, and no graft resorption or secondary complications related to the index surgery were observed. The third case was managed successfully with a bone transport technique.
The induced membrane technique is an alternative good option for the treatment of these severe lesions.
创伤外科中，急性开放性胫骨骨折伴临界骨缺损的处理仍然是一个挑战。关于诱导膜技术治疗此类疾病的报道很少且各不相同。
我们前瞻性评估了 3 例采用诱导膜技术治疗急性 Gustilo ⅢB 胫骨骨折伴临界骨缺损的患者。成功治疗定义为患者无痛且骨愈合。定期进行临床和影像学评估，直至愈合，然后每年评估一次，随访时间至少 5 年。
除 1 例患者外，其余患者分别在 4 个月和 6 个月时记录到成功。这 2 例患者在最终随访时无疼痛，且未观察到移植物吸收或与索引手术相关的其他并发症。第 3 例患者采用骨搬运技术成功治疗。
诱导膜技术是治疗这些严重损伤的另一种较好选择。
